Surety Bond for Closure, Reclaiming and Recycling

OCC/OTC No. ______________ Form 1006BR-B
Bond No. ___________________ (Rev 2012)
OKLAHOMA CORPORATION COMMISSION
Oil and Gas Conservation Division
PO Box 52000
Oklahoma City, OK 73152-2000
(TYPE OR PRINT USING BLACK INK)
SURETY BOND
For Closure and Reclamation of Hydrocarbon Recycling/Reclaiming Facility, Commercial Recycling Facility or Flow Back Water Pit with Capacity in Excess of 50,000 Barrels
OAC 165:10-8-1, et seq., OAC 165:10-9-4 and OAC 165-10-7-16(f)
KNOW ALL MEN BY THESE PRESENTS:
That _____________________________________________________________________, as Operator/Principal,
(Name of the Operator)
Mailing Address: ______________________________ Physical Address: ______________________________
(All Operators MUST include a Physical Address)
City _______________________________ State ________________________ Zip Code __________________
Telephone Number: ____________________________________
Contact Person: _______________________________ Email Address: _________________________________
Emergency Information: Contact Person ___________________________ Phone No. _____________________
And that ____________________________________________________________________________, as Surety,
(Name of Surety Company)
Mailing Address: ______________________________ Physical Address: ______________________________
(All Operators MUST include a Physical Address)
City _______________________________ State ________________________ Zip Code __________________
Telephone Number: ____________________________________
Contact Person: _______________________________ Email Address: _________________________________
authorized to do business within the State of Oklahoma, are held and bound unto said State in the penal sum of $____________________ Dollars, lawful money of the United States, for which payment well and truly be made, we bind ourselves, and, each of us, and each of our heirs, executors, administrators, or successors, and assigns jointly and severally, firmly by these presents.
Lands covered under this irrevocable letter of credit are as follows:
Quarter Section ____ , Section ____ , Township ____ , Range ____, County ________________________
The condition of this obligation is that whereas the above bounden principal proposes to operate a hydrocarbon recycling/reclaiming facility, a commercial recycling facility or a flow back water pit with a capacity in excess of 50,000 barrels at the location designated above pursuant to OAC: 10-8-1, et seq., OAC 165:10-9-4 or OAC OCC Form 1002BR-B
Page 2 of 3
OTC/OCC Operator No. _______________
Bond No. _______________
165:10-7-16(f) and such principal agrees to operate said hydrocarbon recycling/reclaiming facility, commercial
recycling facility or flow back water pit in compliance with Oklahoma Corporation Commission rules and pursuant
to the manner prescribed by the laws of the State of Oklahoma and the General Rules and Orders of the Corporation Commission.
Now, Therefore, if the above bounden principal shall properly close and reclaim the hydrocarbon recycling/reclaiming facility, commercial recycling facility or flow back water pit covered by this instrument at the time and in the manner prescribed by the laws of the State of Oklahoma and the General Rules and Orders of the Oklahoma Corporation Commission of the State of Oklahoma, then this obligation shall expire at that time; otherwise, the same shall be and remain in full force and effect.
This obligation may also be terminated upon six (6) months’ notice in writing by certified mail, return receipt requested, to the Manager of the Oklahoma Corporation Commission’s Surety Department, Oil and Gas Conservation Division, and evidence furnished of alternate surety which is acceptable to the Commission’s Oil and Gas Conservation Division, if such alternate surety is required. Any attempted termination of this obligation is not effective, however, until this obligation is released by the Surety Department of the Commission’s Oil and Gas Conservation Division.
PROVIDED, HOWEVER, the aggregate liability of the surety hereunder this agreement shall in no event exceed the total sum of this financial instrument.
Witness our hands and seals this ______ day of _______, 20_____
____________________________________________
Signature of Principal Officer of Operator
____________________________________________
Type or Print Name and Title of Officer Listed Above
Witness our hands and seals this _____ day of ________, 20_____
____________________________________________
Signature of Principal Officer of Operator
____________________________________________
Type or Print Name and Title of Officer Listed Above
____________________________________________
Name of Surety Company
Countersigned By: ____________________________________
Oklahoma Resident Service Agent
_____________________________________
Physical Address
_____________________________________
City, State, Zip Code
_____________________________________
Telephone Number
OCC Form 1002BR-B
Page 3 of 3
OTC/OCC Operator No. _______________
Bond No. _______________
(If the principal is a corporation, this bond must be executed by a duly authorized officer with the seal of the corporation affixed. If the principal or surety executes this bond by agent or attorney in fact, evidence of the authority of the agent or attorney in fact to execute this bond must accompany this instrument.)

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OCC/OTC No. ______________ Form 1006BR-B
Bond No. ___________________ (Rev 2012)
OKLAHOMA CORPORATION COMMISSION
Oil and Gas Conservation Division
PO Box 52000
Oklahoma City, OK 73152-2000
(TYPE OR PRINT USING BLACK INK)
SURETY BOND
For Closure and Reclamation of Hydrocarbon Recycling/Reclaiming Facility, Commercial Recycling Facility or Flow Back Water Pit with Capacity in Excess of 50,000 Barrels
OAC 165:10-8-1, et seq., OAC 165:10-9-4 and OAC 165-10-7-16(f)
KNOW ALL MEN BY THESE PRESENTS:
That _____________________________________________________________________, as Operator/Principal,
(Name of the Operator)
Mailing Address: ______________________________ Physical Address: ______________________________
(All Operators MUST include a Physical Address)
City _______________________________ State ________________________ Zip Code __________________
Telephone Number: ____________________________________
Contact Person: _______________________________ Email Address: _________________________________
Emergency Information: Contact Person ___________________________ Phone No. _____________________
And that ____________________________________________________________________________, as Surety,
(Name of Surety Company)
Mailing Address: ______________________________ Physical Address: ______________________________
(All Operators MUST include a Physical Address)
City _______________________________ State ________________________ Zip Code __________________
Telephone Number: ____________________________________
Contact Person: _______________________________ Email Address: _________________________________
authorized to do business within the State of Oklahoma, are held and bound unto said State in the penal sum of $____________________ Dollars, lawful money of the United States, for which payment well and truly be made, we bind ourselves, and, each of us, and each of our heirs, executors, administrators, or successors, and assigns jointly and severally, firmly by these presents.
Lands covered under this irrevocable letter of credit are as follows:
Quarter Section ____ , Section ____ , Township ____ , Range ____, County ________________________
The condition of this obligation is that whereas the above bounden principal proposes to operate a hydrocarbon recycling/reclaiming facility, a commercial recycling facility or a flow back water pit with a capacity in excess of 50,000 barrels at the location designated above pursuant to OAC: 10-8-1, et seq., OAC 165:10-9-4 or OAC OCC Form 1002BR-B
Page 2 of 3
OTC/OCC Operator No. _______________
Bond No. _______________
165:10-7-16(f) and such principal agrees to operate said hydrocarbon recycling/reclaiming facility, commercial
recycling facility or flow back water pit in compliance with Oklahoma Corporation Commission rules and pursuant
to the manner prescribed by the laws of the State of Oklahoma and the General Rules and Orders of the Corporation Commission.
Now, Therefore, if the above bounden principal shall properly close and reclaim the hydrocarbon recycling/reclaiming facility, commercial recycling facility or flow back water pit covered by this instrument at the time and in the manner prescribed by the laws of the State of Oklahoma and the General Rules and Orders of the Oklahoma Corporation Commission of the State of Oklahoma, then this obligation shall expire at that time; otherwise, the same shall be and remain in full force and effect.
This obligation may also be terminated upon six (6) months’ notice in writing by certified mail, return receipt requested, to the Manager of the Oklahoma Corporation Commission’s Surety Department, Oil and Gas Conservation Division, and evidence furnished of alternate surety which is acceptable to the Commission’s Oil and Gas Conservation Division, if such alternate surety is required. Any attempted termination of this obligation is not effective, however, until this obligation is released by the Surety Department of the Commission’s Oil and Gas Conservation Division.
PROVIDED, HOWEVER, the aggregate liability of the surety hereunder this agreement shall in no event exceed the total sum of this financial instrument.
Witness our hands and seals this ______ day of _______, 20_____
____________________________________________
Signature of Principal Officer of Operator
____________________________________________
Type or Print Name and Title of Officer Listed Above
Witness our hands and seals this _____ day of ________, 20_____
____________________________________________
Signature of Principal Officer of Operator
____________________________________________
Type or Print Name and Title of Officer Listed Above
____________________________________________
Name of Surety Company
Countersigned By: ____________________________________
Oklahoma Resident Service Agent
_____________________________________
Physical Address
_____________________________________
City, State, Zip Code
_____________________________________
Telephone Number
OCC Form 1002BR-B
Page 3 of 3
OTC/OCC Operator No. _______________
Bond No. _______________
(If the principal is a corporation, this bond must be executed by a duly authorized officer with the seal of the corporation affixed. If the principal or surety executes this bond by agent or attorney in fact, evidence of the authority of the agent or attorney in fact to execute this bond must accompany this instrument.)